MPPA billing channel
The Medical Purchaser Provider Agreement (MPPA) billing channel is a simple method to claim private pathology or diagnostic services for Medibank members.
Find out how to register, claim, and more, below.
If you’re a private pathology or diagnostic imaging provider, a public hospital, or a medical billing agent who represents providers of pathology and radiology services, you can register to claim under the MPPA Billing Channel.
Simply fill out the MPPA Billing Registration form and email it to us as per the instructions on the form, along with a list of providers to be linked to your billing entity(s).
If your registration meets our criteria, we will contact you to discuss potential arrangements.
Note that when approved, you will be registered with both Medibank and ahm.
Please contact us via web messaging or by phoning our provider line on 1300 130 460 to validate your details and access the relevant form.
View step-by-step instructions and further information on making a claim here:
At Medibank and ahm we acknowledge that, in accordance with your billing policies, you may choose to charge our members an out-of-pocket expense for pathology or diagnostic imaging services when they are admitted into hospital. If this is the case, we expect that you will provide our members with a written estimate of fees for each hospital admission and they must give their agreement to any out-of-pocket costs.
For scheduled admissions, this should happen at the earliest opportunity before the admission. For all other admissions, this should happen as soon after the admission as circumstances reasonably allow.
For more information on Informed Financial Consent, click here.
Email your request to MPPA@medibank.com.au including the following details:
- Existing MPPA Billing Entity details
- Provider number of the provider you want to add/remove
- Name of the provider you want to add/remove
- Effective date
This will add or remove their details for both Medibank and ahm.
Please contact us via web messaging or by phoning our provider line on 1300 130 460 to validate your details and access the relevant form.
ECLIPSE is the in-patient claiming system developed by Medicare Australia. It enables providers, health insurers and Medicare to exchange and pay claims electronically.
To register for ECLIPSE or find out more, contact the Medicare Australia eBusiness Service Centre on 1800 700 199 or email co.eclipse@medicareaustralia.gov.au.
You can find a list of the common Medicare rejection codes in our GapCover provider guide.
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